Aortic Coarctation

Aortic coarctation is a narrowing of part of the aorta, the artery that sends oxygenated blood from the heart to the rest of the body. Many people with this condition will not have symptoms until later in life. However, it can lead to hypertension resulting in stroke, congestive heart failure and complications of coronary artery disease.

When the aorta is too narrow, it restricts blood flow to the lower part of the body and increases blood pressure above the narrowing. This means your heart has to work harder to circulate blood to the rest of the body. As a result of the increased work, the heart wall initially thickens, a condition called hypertrophy. If the coarctation is not corrected, heart failure may develop. One of the symptoms of congestive heart failure is breathlessness. If you were born with aortic coarctation, you may have other heart abnormalities such as deformed aortic valves, patent ductus arteriosus or ventricular septal defect.

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High blood pressure above the narrowing also can result in high blood pressure in the arteries that branch out from the aorta, including those in the arms and brain. This may increase the risk of a stroke.

Below the narrowing, the blood pressure may be too low and cause problems feeding enough blood into organs such as the kidneys.

In untreated patients younger than 30 years old, aortic rupture and cerebral hemorrhage are the most common complications. After age 40, the incidence of congestive heart failure increases.

If a person doesn't have severe symptoms at birth, the aortic coarctation may go unnoticed until adulthood. It is most commonly discovered in adults between the ages of 15 and 40, often because the doctor notices a heart murmur in a patient with high blood pressure. Rarely, a patient may come for emergency treatment because of aortic rupture, infection or cerebral bleeding.

In the past, coarctation repair always involved heart surgery through an incision in the side of the chest that required five to seven days in the hospital for recovery. Now it is often possible to correct coarctation without surgery in a procedure called a cardiac catheterization.

Cardiac Catheterization

The heart catheterization consists of placing a long, thin, hollow plastic tube, called a catheter, into the blood vessel in the groin and passing it through vessels into the heart's chambers. The catheter is used to gather blood samples, take pressure measurements and inject dye for X-ray movies. Modern imaging technology allows doctors to see where the catheter is going and how the heart is functioning.